Podcast
Questions and Answers
What method should be used when administering parenteral iron preparations to prevent discoloration and leakage?
What method should be used when administering parenteral iron preparations to prevent discoloration and leakage?
What is a clinical manifestation of megaloblastic anemia due to folic acid deficiency?
What is a clinical manifestation of megaloblastic anemia due to folic acid deficiency?
Which of the following individuals is at highest risk for developing megaloblastic anemia due to folic acid deficiency?
Which of the following individuals is at highest risk for developing megaloblastic anemia due to folic acid deficiency?
What should be avoided prior to administering parenteral iron preparations?
What should be avoided prior to administering parenteral iron preparations?
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What symptom should be monitored for after the administration of parenteral iron?
What symptom should be monitored for after the administration of parenteral iron?
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What is a key component of nursing management for patients undergoing Bone Marrow Transplantation?
What is a key component of nursing management for patients undergoing Bone Marrow Transplantation?
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What is the purpose of reverse isolation in patients with leukopenia?
What is the purpose of reverse isolation in patients with leukopenia?
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Which of the following is an important supportive treatment for patients undergoing BMT?
Which of the following is an important supportive treatment for patients undergoing BMT?
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Sickle Cell Anemia results from the inheritance of which gene?
Sickle Cell Anemia results from the inheritance of which gene?
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What effect does low oxygen tension have on the hemoglobin in sickle cell anemia?
What effect does low oxygen tension have on the hemoglobin in sickle cell anemia?
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What would you expect to find in a CBC for someone with aplastic anemia?
What would you expect to find in a CBC for someone with aplastic anemia?
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Which of the following is a common dietary recommendation for managing sore tongue and cracked lips?
Which of the following is a common dietary recommendation for managing sore tongue and cracked lips?
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Which of the following factors is NOT a predisposing factor for aplastic anemia?
Which of the following factors is NOT a predisposing factor for aplastic anemia?
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What is a primary treatment for patients with malabsorption problems experiencing symptoms similar to those of folic acid deficiency?
What is a primary treatment for patients with malabsorption problems experiencing symptoms similar to those of folic acid deficiency?
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What lab finding would you expect from a bone marrow aspiration in a patient with aplastic anemia?
What lab finding would you expect from a bone marrow aspiration in a patient with aplastic anemia?
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Which of the following symptoms is associated with leukopenia in patients with aplastic anemia?
Which of the following symptoms is associated with leukopenia in patients with aplastic anemia?
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Which of the following would likely NOT be considered in the management of aplastic anemia?
Which of the following would likely NOT be considered in the management of aplastic anemia?
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What are common clinical manifestations of aplastic anemia?
What are common clinical manifestations of aplastic anemia?
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Which condition is characterized by a defect in hemoglobin synthesis leading to hypochromia and microcytosis?
Which condition is characterized by a defect in hemoglobin synthesis leading to hypochromia and microcytosis?
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What initial management strategy is critical in Thalassemia Major to prevent complications?
What initial management strategy is critical in Thalassemia Major to prevent complications?
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Which type of thalassemia occurs mainly in people from Mediterranean regions and can be severe?
Which type of thalassemia occurs mainly in people from Mediterranean regions and can be severe?
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How can polycythemia vera be categorized in terms of cell proliferation?
How can polycythemia vera be categorized in terms of cell proliferation?
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What is a common severe complication associated with untreated Thalassemia Major?
What is a common severe complication associated with untreated Thalassemia Major?
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What is the primary concern when managing patients receiving multiple red blood cell transfusions?
What is the primary concern when managing patients receiving multiple red blood cell transfusions?
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Which intervention is essential for preventing infection in patients with inflamed joints?
Which intervention is essential for preventing infection in patients with inflamed joints?
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What does beta-thalassemia major require for effective management before irreversible damage occurs?
What does beta-thalassemia major require for effective management before irreversible damage occurs?
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Which of the following clinical manifestations is NOT commonly associated with elevated blood cell levels?
Which of the following clinical manifestations is NOT commonly associated with elevated blood cell levels?
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What is one of the first management strategies for reducing blood viscosity in patients with elevated blood cell levels?
What is one of the first management strategies for reducing blood viscosity in patients with elevated blood cell levels?
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Which complication is most likely associated with elevated blood cell counts?
Which complication is most likely associated with elevated blood cell counts?
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Which diagnostic procedure is primarily used to assess blood cell levels in patients?
Which diagnostic procedure is primarily used to assess blood cell levels in patients?
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What is a common nursing recommendation for patients with elevated blood cells regarding exercise?
What is a common nursing recommendation for patients with elevated blood cells regarding exercise?
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Which of the following medications is indicated for managing pruritus in patients with elevated blood cell levels?
Which of the following medications is indicated for managing pruritus in patients with elevated blood cell levels?
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Which condition is characterized by a deficiency or defect in factor IX?
Which condition is characterized by a deficiency or defect in factor IX?
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A patient is experiencing frequent spontaneous bleeding. What is the most critical educational point for managing their condition?
A patient is experiencing frequent spontaneous bleeding. What is the most critical educational point for managing their condition?
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In hemophilia management, which of the following treatments helps stabilize the clot?
In hemophilia management, which of the following treatments helps stabilize the clot?
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Which clinical manifestation is most commonly associated with hemophilia?
Which clinical manifestation is most commonly associated with hemophilia?
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Study Notes
Iron Supplementation
- Use a soft bristled toothbrush
- Avoid extreme temperatures
- Administer parenteral Iron preparation via Z-tract method to prevent discoloration and leakage
- Do not massage the injection site, encourage ambulation instead
- Monitor for side effects including: pain at injection site, localized abscess, lymphadenopathy, fever and chills, and skin rashes
- Watch out for anaphylaxis due to parenteral Iron supplement
Megaloblastic Anemia: Folic Acid Deficiency
- Occurs if there is folic acid deficiency within 4 months
- Risk factors include: rarely eating uncooked vegetables, alcoholism, chronic hemolytic anemia, pregnancy, and malabsorptive diseases of the small bowel
- Clinical manifestations include: fatigue, weakness, pallor, dizziness, headache, tachycardia, sore tongue, and cracked lips
- Diagnostic procedure involves CBC, showing decreased RBC, hemoglobin, and hematocrit with increased mean corpuscular volume and mean corpuscular hemoglobin concentration
- Management includes: administering 1mg of folic acid daily, folic acid intramuscular for patients with malabsorption problems, and small frequent meals of bland, soft food if sore mouth and tongue are present
- Diet should be rich in folic acid, such as beef liver, peanut butter, red beans, oatmeal, broccoli, and asparagus
Aplastic Anemia
- Rare disease caused by a decrease in or damage to marrow stem cells, damage to the microenvironment within the marrow, and replacement of the marrow with fat resulting in pancytopenia (decreased RBCs, WBCs, and platelets)
- Predisposing factors include: chemicals (benzene & its derivatives, pesticides), radiation, immunologic injury, drugs causing bone marrow depression, broad-spectrum antibiotic, chemo therapeutic agents, attack of T-cells against bone marrow, infections, and pregnancy.
- Clinical manifestations include: pallor, weakness, fatigue, exertional dyspnea, palpitations, fatigue, infections associated with Leukopenia (fever, headache, malaise, abdominal pain, diarrhea, erythema, pain, exudate at wounds or sites of invasive procedures, Lymphadenopathies and Splenomegaly), and Thrombocytopenia (bleeding from gums, nose, GI or GU tracts; purpura, petechiae, ecchymoses, retinal hemorrhage, oozing of blood from venipuncture site)
- Diagnostic procedures include Bone Marrow Aspiration showing an extremely hypoplastic or even aplastic (very few to no cells) marrow replaced with fat, and CBC and peripheral blood smear showing decreased RBC, WBC, and platelets (pancytopenia)
- Management includes: removal of causative agent or toxin, Bone Marrow Transplantation (BMT) or Peripheral Blood Stem Cell Transplant (PBSCT), Immunosuppressive therapy, and supportive treatments including platelet and RBC transfusions, antibiotics, and antifungal administration
- Nursing management includes: administration of immunosuppressants, blood transfusions, complete bed rest, oxygen administration, teaching the patient how to minimize risk of infection, reverse isolation due to leukopenia, monitoring signs of infection, and avoiding SQ, IM injections, use only soft toothbrush for mouth care, and electric razor for shaving
Sickle Cell Anemia
- Severe hemolytic anemia that results from inheritance of the sickle hemoglobin gene
- The abnormal sickle hemoglobin (HbS) acquires a crystal-like formation when exposed to low oxygen tension
- Support and elevate acutely inflamed joint
- Implement relaxation techniques
- Prevent and manage infection by monitoring patient for signs and symptoms of infection and initiating prompt antibiotic therapy
- Monitor and prevent potential complications by providing adequate hydration, avoiding cold temperatures, protecting the leg from trauma and contamination to prevent leg ulcer, and utilizing aseptic technique
Thalassemia
- Group of hereditary anemias characterized by hypochromia, extreme microcytosis, destruction of blood elements (hemolysis), and variable degrees of anemia
- Associated with defective synthesis of hemoglobin; the production of one or more globulin chains within the hemoglobin molecule is reduced
- Alpha-thalassemia occurs mainly in people from Asia and the Middle East and are milder than the beta forms and often occur without symptoms
- Beta-thalassemia are most prevalent in people from Mediterranean regions; Patients with mild forms have microcytosis and mild anemia; Severe beta-thalassemia (i.e., thalassemia major or Cooley’s anemia) can be fatal within the first few years of life if untreated
- Management includes: Bone Marrow Transplant and blood transfusion of Packed RBSs
- Thalassemia Major (Cooley’s Anemia) is characterized by severe anemia, marked hemolysis, and ineffective erythropoiesis
- With early regular transfusion therapy, growth and development through childhood are facilitated
- Management of Thalassemia Major includes: PBSCT before liver damage occurs, and monitoring for and managing iron overload which results from excessive iron in multiple packed RBC
- Management of iron overload: regular chelation therapy
Polycythemia Vera (Primary Polycythemia)
- Proliferative disorder of the myeloid stem cells
- The bone marrow is hypercellular
- Elevated levels of blood cells (erythrocyte, leukocyte, platelets)
- Clinical manifestations include: ruddy complexion, splenomegaly, headache and dizziness, tinnitus, fatigue, and paresthesia, blurred vison, increased blood viscosity (angina, claudication, dyspnea and thrombophlebitis), elevated blood pressure, elevated uric acid (gout and renal stone formation), generalized pruritus, and Erythromyalgia (burning sensation in fingers and toes)
- Diagnostic procedures include CBC and Bone Marrow Aspiration
- Complications include: Cerebrovascular Accident, Myocardial Infarction and bleeding due to dysfunctional large amount of platelet
- Management includes: Phlebotomy (removing enough blood to reduce blood viscosity and deplete the patient’s iron stores), Chemotherapeutic agents (eg, hydroxyurea) to suppress marrow function, Anagrelide (Agrylin) to inhibit platelet aggregation, Interferon alfa-2b (Intron-A) to manage pruritus (WOF: flulike syndrome and depression), Antihistamine, and Allopurinol
- Nursing management includes: instructing the patient to avoid sedentary behavior, crossing of legs, wearing tight or restrictive clothing, avoiding aspirin and aspirin-containing medications, minimizing alcohol intake, avoiding iron supplements, bathing in tepid or cool water, avoiding vigorous toweling off after bathing, and using cocoa butter or oat meal-based lotions and bath products
Hemophilia
- Inherited bleeding disorder
- Hemophilia A is caused by genetic disease that results in deficient or defective factor VIII
- Hemophilia B (Christmas Disease) is caused by a genetic defect that causes deficient or defective factor IX
- Both types are inherited as X-linked traits, so almost all affected people are males; females can be carriers
- Recognized in early childhood, usually in the toddler age group
- Clinical manifestations include: hemorrhages into various parts of the body, Hemarthroses and hematomas (75% of all bleeding occurs into joints), chronic pain or ankylosis (fixation) of the joint occurs, spontaneous hematuria and GI bleeding, and intracranial or extracranial bleeding - most dangerous
- Management includes: administration of factor VIII and factor IX concentrates, infusion of fresh frozen plasma, plasmapheresis or concurrent immunosuppressive therapy, Aminocaproic acid to inhibit fibrinolysis and therefore stabilizes the clot, and Desmopressin (DDAVP) to induce a significant but transient rise in factor VII levels
- Nursing management includes: assisting the child in coping with the condition, encouraging self-sufficiency and independence by preventing unnecessary trauma, instructing the patient to avoid OTC medications, nasal packing, injections, providing splints and other orthopedic devices, and warm baths to promote relaxation and improve mobility
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Description
Test your knowledge on key aspects of iron supplementation and megaloblastic anemia, specifically focusing on folic acid deficiency. This quiz covers administration techniques, monitoring for side effects, and risk factors related to anemia. Determine how well you understand these critical topics in nutrition and hematology.
